Yesterday I wrote about the ways in which the Baby Friendly Hospital Initiative (BFHI) is hurting babies (Help me stop the Baby Friendly Hospital Initiative before more mothers and babies are harmed). It appears that the incidence of severe dehydration, sometimes accompanied by permanent brain damage, is rising as well as the incidence of skull fractures of babies who fall from their mothers’ hospital beds, and infants being accidentally smothered by their mothers who fall asleep while feeding or cuddling them.

I advocated for ending the BFHI on the twin grounds that it is not friendly to babies and it doesn’t work to promote breastfeeding. The BFHI is going to be around for the near future, though. How can mothers protect their babies and themselves from the misguided totalitarian rules of the BFHI that muzzle nurses preventing them from telling you about the options for feeding your baby?

Women who have easy access to formula supplementation in the first few days are MORE likely to breastfeed successfully.

If you want to be successful at breastfeeding, I recommend bringing formula to the hospital.

I recommend it for both practical reasons and philosophical reasons.

The practical reasons include:

We KNOW that many women won’t have their milk come in for more than two days after birth, but babies may get hungry before then.

We KNOW that 5-15% don’t make enough breastmilk to fully nourish and infant.

We KNOW, as even Dr. Alison Stuebe of the Academy of Breastfeeding Medicine acknowledges, that as many as 44% of babies will need formula supplementation in the early days.

In other words, women who have easy access to formula supplementation in the first few days are MORE likely to breastfeed successfully, not less. The BFHI explicitly ignores this.

Why?

In my view it’s because the BFHI is designed to be both humiliating and punitive.

The BFHI mandates refusing to offer supplementation to hungry babies.

It forces mothers to beg for formula and subject themselves to lectures on the benefits of breastfeeding (as if they are idiots and aren’t already aware).

It muzzles postpartum nurses from appropriately counseling women about the risks of dehydration and the benefits of supplementation.

It prohibits soothing hungry infants with pacifiers even though there is no evidence that pacifiers interfere with breastfeeding and a growing body of evidence that they reduce the risks of SIDS (sudden infant death syndrome).

Why is it designed to be humiliating and punitive?

Because the proponents of the BFHI cling to the beloved fiction that women don’t breastfeed or stop breastfeeding because they are too stupid and gullible to resists the marketing of formula manufacturers when the truth is quite different. The truth is that women don’t breastfeed because initiating breastfeeding can be frustrating for both mother and babies, and painful. They stop breastfeeding because continuing may be frustrating, painful, inconvenient and may fail to provide the baby with enough nutrition.

The BHFI folks fear that if mothers see how easy, convenient and satisfying formula is, women will be seduced into using it instead of breastfeeding. So they prattle on about how easy and convenient breastfeeding is when it’s neither. They babble that breastmilk is the perfect food when it isn’t perfect if there is not enough of it. And, of course, they grossly exaggerate the benefits of breastfeeding when the truth is that in countries with clean water the benefits are limited to a few less ear infections and episodes of diarrheal illness across the entire population of babies in the first year.

Women are not selfish fools who must be forced into breastfeeding. Most women want to breastfeed and will make strenuous efforts to do so.

If you are one of those women I recommend that you take both formula and pacifiers to the hospital. Your baby will probably never need the formula, but knowing you have it will be reassuring. If your baby screams incessantly from hunger, you can offer a little formula to settle her and allow her (and you) to get some sleep. Pacifiers can also help in bridging the gap between your baby feeling distressed and your milk coming in.

The practical reason for bringing formula and pacifiers is that they can promote successful breastfeeding, but there’s a philosophical reason, too:

Having easy access to formula and pacifiers puts mothers, not lactation professionals, in charge of both babies and their own bodies. It eliminates the ability of hospital personnel to pressure and humiliate women into fulfilling the hospital agenda and leaves personal decisions to the person actually affected by them, the mother.

Lactation professionals and all healthcare providers should never forget:

HER baby, HER body, HER breasts, HER choice!

If you want to control your own body AND ensure a successful breastfeeding relationship, take formula to the hospital. You probably won’t need it, but if you do, you’ll be very glad you brought it.

I just had my second C section at a baby-friendly hospital–luckily, the staff there is amazing, and sane enough to practice moderation in most things, so while there is no official well-baby nursery, the nurses will take your baby to the nursing station for a few hours to let you sleep as long as they aren’t too busy (it’s a small regional hospital). I was super impressed with the level of care I received BUT it was all down the nurses themselves being awesome. I simply could not believe that as a mother recovering from surgery, I was (ideally, according to policy) expected to room in with a baby 24/7.

First of all, most newborns, including mine, do NOT sleep happily in a bassinet, on their backs, right out of the womb. And we aren’t allowed to co-sleep (for good reason), even though I fell asleep several times while holding the baby because duh, I was under the influence of heavy narcotics! So what the policy is saying is, a mom who has already been up for 2 days (in my case, both times) and just got out of surgery should then stay up holding her baby for the next 3-4 days she is required to be in the hospital after surgery? WHAT? It makes zero sense to me and is downright criminal, considering what we know about sleep deprivation and psychosis, let alone the normal postpartum mental health vulnerabilities. Sure I had my husband and mom around, but my husband has a mental health condition which means that he cannot skip sleeping for any serious length of time and my mom was busy helping out with my toddler at home.

Ultimately, I arrived home luckily having had a few stretches of 2-3 hours of sleep because the nurses had mercy on me. But I still had only slept maybe 7 hours total in 2-3 days. I felt like I was losing my mind. For this reason, with both of my kids, the hospital stay and the first few days home were the worst part of my experience…at least it is something I will never, ever go through again, thank GOD.

Evie

Totally agree with this – I was so sleep deprived and jacked up on strong pain medication following my C section (and prior blood transfusion) that I found it crazy to provide care for my baby 24/7, no nursery on site. One of the nurses did find me asleep one morning with the baby on my chest, proving how I wasn’t in the best state to be handling her. Thankfully they had formula there and without it my baby would not have flushed out the jaundice they had within first 24 hours when my milk was nowhere near coming in after a CS, plus her low birth weight and tongue tie preventing her from latching on properly/getting too tired to suckle. I was also keen for baby to put on weight fast and you can only really do that with formula which has the extra calories.

EmN

I dont hate formula but find this article a bit weird…..what are you expecting when you have a baby? That it will be happy in a plastic box in a nursery feeding every 4 hours while you have a sleep? I totally agree that breastfeeding is not more important than feeding full stop and letting your baby get dehydrated and jaundiced is unacceptable but frequent feeding, crying and a need for close body contact are totally.normal. I’m a veterinarian and wasn’t particularly attached to breastfeeding over bottle from a philosophical standpoint but we are mammals and if you take any baby animal away from its mother it will scream. All baby animals feed frequently and are comforted by it. There is no issue with formula supplementation where necessary or exclusive ff if chosen but good support for breastfeeding is hugely important. It is normal, free, clean and biologically what our breasts and bodies are made to do as is the case for all mammals. Why can’t people just do what is best for them, grow a pair and stand by your own decisions and stop getting worked up about either option?. There is much more to mothering than feeding choices but natural is logical. My son was tongue tied and refused a bottle and we’re still struggling 3 months in but he is thriving and I wouldn’t make any feeding choice that jeopardised his health. Case by case basis…

Inmara

“Why can’t people just do what is best for them, grow a pair and stand by your own decisions and stop getting worked up about either option?” Indeed, why can’t lactivists and BFHI proponents just stop getting worked up about mothers who make a decision to supplement, combo feed or EFF? That’s what all these Dr. Amy’s blog posts are about.

Annie

I’m confused by this comment.
Which article did you read?
Dr. Tuteur did not advocate for leaving a child in a plastic box in a nursery, relying on limited touch and formula feeding every four hours.

She does suggest that the pressure for a baby to be relentlessly attached to its mother 24/7 (via continuous breastfeeding, and rooming-in) may be unsafe for *some* mothers and babies (eg. mothers who are completely exhausted; mothers who have had significant injury with birth; mothers who do not have the emotional resources to cope, as in postpartum depression)

I agree that as mammals, babies need human contact…but that human certainly does not have to be its mother. If a mother is unwell, the baby can still thrive being cuddled by fathers, other family members, or nurses who are willing to take the baby for short periods of time so that a mother can recover.

There is a reason you must put your oxygen mask on first in a plane crash, before helping children and the elderly. If you do not have enough oxygen, you will pass out before being able to do an ounce of good for others. Forcing exhausted mothers to be the sole carers of newborn babies, and not offering them tangible support or respite at a physically and emotionally arduous time, puts them at risk for poor health. And those who cannot look after themselves, certainly will have more difficulty, trying to care for a newborn baby.

LibrarianSarah

Am I the only one amused by EmN using a logical fallacy and calling it “logical?”

sdsures

Nope.

She said, “[Breastfeeding] is normal, free, clean and biologically what our breasts and bodies are made to do as is the case for all mammals.”

God, how many times has it been repeated on here that some women do not produce enough milk to nourish a baby, and others simply do not want to breastfeed? It is NOT free because of the time it takes the mother to do it, when she could be spending time actually having fun with and caring for her baby. It can be too stressful for those with a low supply.

“There is much more to mothering than feeding choices but natural is logical.”

The above statement rests on presuppositions and backpedalling.

swbarnes2

People are expecting the new mothers who might be recovering from pph, or pre-eclamsia, or surgery, or be on strong pain meds, should be treated as patients, not as caregivers for other patients. Nowhere else in the hospital is a person recovering from a day-long medical ordeal expected to be responsible for the health and life of other patients, to the detriment of their own recovery.

Valerie Reinhard

With my first-born, I had pre-eclampsia and HELLP. I was on mag-sulfate for several days, and totally loopy/out-of-it. The baby roomed in with me, and the nurses encouraged breastfeeding like crazy (my poor chest was covered in bruises, because of my low platelets). It wasn’t until recently that I looked back at how bizarre that was. I couldn’t even sit up in bed, and they had me rooming with my baby? I’m so glad that my poor baby survived his loopy, sick mama trying to care for him those first few days (and thankful for one sweet nurse who saw me struggling and took him back to the nurses station with her for a few hours).

sdsures

Wouldn’t post-op narcotics be transferred through the breastmilk to the baby? In that case, fomrula would be the only safe choice.

She

Wow. I’m so grateful for how nicely we were treated after reading these comments. I had a difficult labor and a c-section and my milk didn’t come in for 7 or 8 days. I was given pain meds, told it was fine to supplement with formula, and given a pacifier to use if we wanted to. I did nurse exclusively for a few days until baby got tired of so much work for no reward and flat-out refused to do it anymore. We were home by that point and I was very grateful to have some formula to feed him. He hadn’t eaten for 12 hours and I couldn’t let it go on, not when i had an alternative.

What a load of crap!!!

this is the stupidest thing I have ever read. You guys owe me time wasted on reading this crap. Then again I can’t take this bs seriously considering the source. This is why most women can’t be bothered to do what’s best for their kids. This right here. People spreading stupidity and ignorance.

sdsures

How insightful. Not.

Annie

My baby had severe jaundice because I wasn’t making enough milk.

I was the picture of health; no high risk features, young, highly educated, highly motivated and fit. Yet, despite a “perfectly normal” birth, I still got a very, natural infection from endometriosis and a perfectly natural perineal tear, which caused significant pain. And pain, fatigue, infection all contributed to my lack of milk, despite my attempts to latch baby non-stop for two days.

As I recovered from these things, guess what? We gave baby formula. And when I was well, my milk came in and we successfully breastfed for a year.

I’m guessing you have either not had children yourself or happened to have an easy time, where everything lined up and you did not need formula. This is not the reality for most women. And many of the women I know when actually breastfed for extended periods of time, had to supplement briefly.

MaineJen

…well, I just wasted about 20 seconds reading your paragraph, so let’s call it even.

First Time Mama

After hearing the horror stories of some baby-friendly hospitals, I feel very lucky that my experience last year was so positive. The hospital provided formula at my request, and while I tried to nurse in the hospital, we had some troubles getting started. Several of the nurses explained to me that my baby was a ‘steak and potatoes’ kind of girl, and I was only offering her a garden salad at that point. If anything, they encouraged me to judiciously supplement with formula. I’m happy to report we did eventually get the hang of nursing–11 months, and she’s still going strong, all thanks to her start with formula!

Kelly

I love that kind of description. I had two of those.

Puffin

A lethargic, starving, dehydrated baby is just not going to transfer milk efficiently if it’s available, and isn’t going to suck vigorously enough to bring it in if it isn’t.

Of course feeding the baby is going to increase successful breastfeeding. Birth and learning all these new skills takes energy; they need to get it from somewhere and their teeny bit of glycogen isn’t going to keep them going for several days when they are expending several times their foetal energy demands just to keep warm, and breathe, and lift their limbs against gravity, and cry, things they didn’t have to do themselves until birth. I don’t get why this is a concept that so evades most hospitals. You can’t starve a newborn into compliance with your policies.

Irène Delse

This is so true. I remember a friend who gave birth recently. She had always intended to breastfeed, but immediately after birth, neither her not the baby were feeling up to it. She told me the poor little girl was screaming in a kind of panic, possibly due to being tired, and couldn’t manage to suck. Thankfully, there was a nurse with experience in newborns and new moms who gave the baby some formula in a dropper, which made the baby a lot happier. Shortly after, she started sucking in earnest and the breastfeeding relationship went on for 2 1/2 years.

sdsures

I have often felt as an adult that I’m too tired to eat. Know the feeling. Glad she’s doing better!

Kelly

Oh crap, is that bad that I have never ever felt too tired to eat?

sdsures

You’re human. 🙂 I have chronic pain, so cooking requires more energy, so by the time it’s ready to eat, I’d rather just sleep and have whatever it is for breakfast.

Kelly

I understand that.

Felicitasz

HOW VERY TRUE. Thank you, McMaster Hospital (Hamilton Health Sciences, ON, Canada), for giving away all those bottles of ready-to-feed formula, even if only 5-10 ml at a time were needed at the very beginning, and I drank the rest (well-absorbing iron after a C/S, hey, I will NOT drain the leftover into the sink :)) Thank you for giving me those bottles to take home on day 4, with an already established – albeit fragile – nursing schedule. “Of course you can take them … you know what, take this full box (of 10 bottles)… I could swear right here that you will never need it but it is very important that you feel relaxed because you have some baby food readily available no matter what.”
She was right, I ended up using the formula for baby cereals etc., much later.
Thank you for this post, and especially its title.

Puffin

How recently was this, if I may ask?

Felicitasz

2007. Still the fondest memories.

conky3000

My experience at Lakeridge Health in Oshawa (Ontario, Canada) was very similar. The nurses were awesome for encouraging and supporting breastfeeding and just as supportive when I wanted to get right on supplementing when my daughter was losing too much weight. They brought me formula, showed me how to cup feed (after giving the option of cup, bottle or tube), and didn’t make me feel guilty for even a second. They also sent us home with an 8 pack.
This was in contrast to my first hospital experience (North York General in Toronto) when I had twins who were screaming their heads off and losing weight (plus my blood pressure was high, I was exhausted and did I mention I had TWINS) but nobody ever mentioned supplementig with formula. When I think about how hungry they were and how they weren’t having wet diapers when we brought them home, I stil feel terrible. It’s very difficult to look back on that time. I should have been supplementing very early on but nobody said a word.at least this time I k ew better. We’re two months in and I’m still breast and formula feeding and it’s been a much better experience. .

Gene

One of my newborn patients this week had been steadily losing weight at home. Mom’s milk still hadn’t come in and kiddo was quite jaundiced (but a hair below treatment level). Plan was the return to PCP the next day for recheck (no rec for formula of course). Because “things”, kiddo ended up in my ER now >10% birthweight lost, low blood sugar, much higher bili level, ended up admitted to NICU.

This is such a common scenario and happens all the god damned time! Another baby sacrificed on the alter of the almighty breast.

Dr Kitty

Do you have a Significant Adverse Event reporting mechanism?
Can you file every single one of these cases as an adverse event?
Would enough of them trigger a review?
Or could you audit re-admissions via ED for jaundice and/or dehydration and present it at an M&M?

I don’t know. I felt like I was screaming into a void trying to fight against the “no take home opioids for BF women” policy.
Now I just give women opioids and advise them to file a formal complaint about the negligent under treatment of their acute post-operative pain.

Fleur

The expectation was that, after my c-section, I’d be discharged after 24 hours as that was hospital policy for elective sections. I managed to hold out until 48 hours because I’m a single mother without 24/7 care at home. I wasn’t allowed to take anything home other than paracetamol and ibuprofen, neither of which have ever had any effect on my usual menstrual cramps, let alone the pain of having undergone abdominal surgery. I’ve had vivid nightmares since then about that pain (that, and the pain I was in for a couple of hours the day after the op, when the midwives were too busy to bring me painkillers after my epidural wore off). My c-section was great and I’m so glad for my daughter’s sake that I went down that route, but the aftercare has convinced me that I don’t want to try for a second child.

guest

That is just awful. I had an emergency c-section, but afterwards the pain management was more than adequate, and I stayed in the hospital for four days (though I was also being monitors to make sure my pre-e went away).

conky3000

That’s horrible! After my c section two month ago I was given a prescription for percocet, so I took that and regular ibuprofen…after the first week I was down to just the occasional ibuprofen as needed. I can’t imagi e how I would have managed that first week with just regular acetaminophen and ibuprofen!

sdsures

That’s crazy!

Annie

This is absolutely horrifying. C-sections should have a minimum 48 hour stay. The recovery from a C-section should be treatment like a recovery from any abdominal surgery, and be met with pain control strategies and support.

Gene

I don’t think it would qualify as a SAE because it us worsening at home as opposed to in the hospital. But a lot more are actually sent home (thankfully) because they are still perky enough to take a bottle (and get sent home from the ED with a bunch of ready made bottles).

Regarding M&M, we all know it happens, so I doubt an M&M would do much.

Mrs.Katt the Cat

“the alter of the almighty breast.”

The image my brain created to go with that statement is hilarious. Just felt the need to share that. Jiggly boobs everywhere!!!

Megan

I am not in the ER like you but I have noticed that our nursery (which is where babies readmitted for jaundice go) now always has at least one baby under the lights and sometimes as many as 3 or 4. We do not have a NICU. The nursery as little as 5 years ago used to be empty most of the time except for well babies but now that we are owned by a bigger health system and they have implemented the Keystone 10 (Pennsylvania’s version of BFHI), this change has occurred. I do not have hard numbers on this, just my own observation, but that’s my anecdata. It would be interesting to start tracking these readmissions.

sdsures

I hope he recovers!!

CSN0116

My 4-year-old feeds my infant every morning and has since she was born. Snapped this gem this morning when she wasn’t looking 🙂 #omgformulaisinthatbottle #fedisbest

Megan

That is frickin’ adorable. Even made my husband say “Awww”

MaineJen

Clearly they are both traumatized by teh evil, evil formula. /sarc

Beautiful kids!!

demodocus

awwe

KeeperOfTheBooks

Now THAT is a picture that should be kept and framed! I love it!

Bombshellrisa

I LOVE this!!! Precious!!

sdsures

YMMD!

Brooke

Part of the problem with your side is that you glamorize bad parenting. Its not your 4 year olds job to feed YOUR baby. Just like you should use water that’s been boiled for formula.

Irène Delse

Aren’t we grumpy, today! What’s wrong with encouraging a child who wants to help with feeding their little brother or sister? Oh and, FYI, there’s several brands of bottled water that are perfectly acceptable for diluting formula.

Kelly

No, you don’t have to boil water if you have safe water coming out of your faucet. I have fed three children with formula and have never boiled the water first. They are all very healthy. Also, my four year old loves to feed her sister. So now siblings can’t bond over feeds. By the way CSN0116, this one of the cutest pictures I have ever seen. I have some of my children feeding their siblings and it always gives me the feels.

AllieFoyle

Part of what problem? If you look at that picture and see anything other than sweetness, I’d say that you have the problem.

CSN0116

Like it’s not the JOB of your Baby Daddy #1 to take in you and your newest infant because deadbeat Baby Daddy #2 didn’t want to do it? Or like it’s not the JOB of the fine State of MA? Shit, my kid might occasionally get fed by others, but she’s not wholly sustained by them, unlike you.

CSN0116

And what in this picture or caption indicates whether or not the water was boiled?!

Stop getting your info from WHO (where the W = WORLD). In places that aren’t developing, with water purification systems in place, NO need to boil – genius.

I know when I was little, I wanted to help feed the baby. I don’t see any child labor in there, just letting a little girl be a big sister and help care for her baby sibling. Why do you think that’s bad parenting in any way, shape, or form? Don’t you want siblings to bond too?

Steph858

WRT dummies (referred to as pacifiers in the article):

I heard nurses telling mothers of term babies on my ward not to give their babies dummies because it interfered with breastfeeding. I was surprised to hear this: the nurses looking after my son kept a dummy right there in his incubator! When I asked why he was being given a dummy when dummies were supposed to be so bad for babies, I was told that it’s ‘different’ with prem babies.

Another mother with a prem baby – whose cynicism puts me to shame (in a good way) – said this: “Yes, it’s different: with prem babies, the nurses have to look after them and they don’t want a baby screaming all through their shift. But with term babies, it’s the mother who has to deal with all that noise.”

Not sure if that was the reason, but I suspect it’s closer to the truth than whatever the ‘official’ reasoning is.

guest

My niece’s daughter was sucking her nipples off for comfort in the hospital and when I suggested giving the baby a pacifier, the nurse gave a lecture on why that was a bad idea. When my daughter was born preterm, the nurse looked relieved when I suggested a pacifier for her. Only difference, my baby was going to the nursery and my nieces baby wasn’t. I think you’re on to something there.

Erin

My term son spent a couple of nights in NICU. They insisted I either allowed them to give him formula or a pacifier as he was “bullying” the premies by screaming his head off whenever I left him. I think she was spot on.

sdsures

I wouldn’t call it “bullying”. It’s not his fault.

guest

The pacifier is more important with preemies, because they often have a weak suck reflex. It helps them practice. I’m sure the nurses also prefer not to have multiple screaming babies that they can’t pick up and soothe.

sdsures

Yep, that’s what I was told. (I was a 28-weeker.)

Steph858

So why didn’t they just tell me that instead of responding with the inscrutable “It’s different with preemies”?

Thanks for the info though. I’d been wondering about that for a while.

Anna

One more reason to bring your own formula to the hospital: hospital formula may not be of the highest quality, whereas your own formula purchased in advance is more likely to suit your baby better.

demodocus

i’m bringing a store generic

KeeperOfTheBooks

The only reason I’m not is that Enfamil has quite kindly sent me some boxes of RTF nursettes, which I’ll be packing just in case. Yay cheaper-yet-entirely-comparable generics!

Kelly

I also get the coupons and buy the RTF nursettes as backup for the car and the diaper bag in case I run out or forget formula. (this has been the first baby where I completely forgot formula. The kids are scrambling my brain)

Gene

Umm, I’m going to need some references for that claim. All formula sold in the US must meet certain minimum standards. Every hospital in which I’ve worked has used one of two different national brands (either enfamil or similac) and has every possible version (regular, soy, elemental, preemie appropriate, etc).

KeeperOfTheBooks

IIRC (and as ever, my memory may be wrong), Anna isn’t in the US–possibly somewhere in Eastern Europe? The situation there may be a bit different than it is here, though your description of the situation in the US is quite accurate. 🙂

Chant de la Mer

There is a series of posts by the Pediatric Insider that says all the regular formulas are pretty much the same, maybe the flavor changes a bit from brand to brand but they all offer pretty much the same ingredients and nutrition. The same for the soy formulas, the difference starts when you get to the specialty formulas for special needs like the alimentum or nutramigen formulas. That series of posts about formula was really interesting and offered a lot of practical information. I think the big differences were the types of sweetener used like rice syrup vs. corn syrup and that the organic ones were sweeter than non-organic. Several were offering extra vitamins that might be good for brain development but it was a few years ago and I think all formulas are offering that now. Most hospitals offer either similac or enfamil in RTF and some even offer your choice. Mine had enfamil as it was the version less expensive in local stores and they served a lower income population.

guest

Could you provide us with a ranked list of formula by quality?

Sarah

Hi, Dr Amy or any commenters, any chance you know of references for the 5-15% not having enough breastmilk? I am a tutor in a medical school and our students are taught that it’s only 1% or less. I doubt this and would like to approach the staff involved with any papers that might suggest the number is higher (or indeed confirm the 1% if that is in fact the case). Not my specific area (oncology) and work plus fanily means Im never getting time to look myself, any chance anyone knows some reliable references offhand? Thanks in advance…

Anne Catherine

Here are a few on that and dehydration that I have compiled over the years. I hope the links work!!

(the full text is more informative)
..Prospective studies with full lactation
support consistently show that approximately 15% of exclusively breastfed infants develop excessive weight loss, exceeding 10% of birth weight, within the first week of life.1 Approximately one-third of these infants will be hypernatraemic (sodium ≥150 mEq/L). The incidence of breastfeeding-associated hypernatraemia among hospitalised term and near-term neonates is 2%….

Reader Valerie has dived in this topic and found a reference to the one study from where this number comes, maybe you can look through her Disqus posts. But I hope Dr. Amy will make a post on this because it’s ridiculuos how underresearched this topic is.

Megan

Yes, it’s a question that’s come up often enough that I think it warrants a post also. I know I’ve said it before but in my experience the number is somewhere around 15-20%.

Sarah

Thanks, will search. I agree it would be good to have an evidence-based post on this!

sdsures

Somewhere there was a recent discussion about how lacking in information about breastfeeding, formula-feeding, etc is, with regard to medical school. They just don’t learn the stuff they need to, like the 5-15% statistic.

Sarah

Thanks everyone, I’ll start with these!

Felicitasz

1 % is A LOT OF PEOPLE and even more births, even if that number is correct. (And there should be a distinction between “temporarily” not having enough, say, at the beginning or in certain phases, or just not having enough as it is, and wanting to supplement with formula all the time.)

Ah yes, there is only one type of body in Brookeland, the kind that works reliably and easily every time. No variation at all.

Oh, wait, that’s machinery I’m thinking of.

There’s a reason Brooke spends all her time agitating in comment sections.

Linden

When has *machinery* worked reliably every time, even?
You’re thinking the laws of physics (which we haven’t fully sussed).

Sean Jungian

I wanted to say “automatons” but I couldn’t think of the word in time (and it suffers from the same flaw you mention).

You are right, there is nothing we know of that is 100% efficient and 100% reliable. Unless we go to Brookeland, where every human mother’s body is exactly that!

lilin

There is no “now” about this discussion. There have always been women who don’t produce enough food of any kind to feed their babies. For that matter, there have always been animals that don’t produce enough food to feed their babies.

Acknowledging that and dealing with it is not some kind of plot against breastfeeding.

momofone

I’m guessing there’s also a reason you can’t stay away.

D/

While I never touched it in the course of helping the 17 mothers and their 36 babies that I belonged to today, anyone wanna take a peek at what rode around in my pocket all day?

I absolutely trust breastfeeding … exactly as far as it proves itself trustworthy.

Bombshellrisa

Love it!

Who?

Oh honey.

Don’t shake too hard, you need to be careful of what brain cells are there.

guest

How would you feel if someone told you two canapes was plenty of food before dinner….five to seven days from now?

Bombshellrisa

I don’t think Brooke knows what a canapé is.

Charybdis

It’s that thing that hangs over a bed, isn’t it?

😛

sdsures

Brooke needs to read “Alive” by Piers Paul Read.

Azuran

Yea, and that reason is because she decided to raise her kids.

Congrats, you’ve guessed right: Sometime women will not produce enough breastmilk or colostrum or whatever to feed a baby for the first few days after birth. See, it wasn’t so hard to understand.

sonora

I produced NOTHING in the first 10 days. Not even a few drops. Tried pumping, hand expressing, nothing came out. I went straight to milk after I finally started producing something 10 days later, never produced colostrum. I breastfed until my child was three, I didn’t stress about not having milk and fed formula for those 10 days. I would have been perfectly fine continuing to formula feed if my body never got into gear. My breastfeeding beginning was phenomenal because my child never went hungry because she got formula, and was strong enough to latch on as soon as my boobs overflowed and I was not stressed because I was able to have some sleep since my husband was able to share in the feeding to give me recovery time.

CSN0116

A lot of the people here actively practice medicine. Are they irrelevant too? Exactly what status does a medical licence have to be in to be relevant to you?

You’re thee most undereducated person who comments here – literally and figuratively – yet you sound off about the importance of current credentials and everything *you* say is right, despite no formal higher education. Walking contradiction.

Megan

With my first baby I produced only a few drops of colostrum and that was only if I used both hands to wring it out. I had no milk until day 8. The breasts aren’t any different than anything else in the body. Sometimes they don’t work as advertised.

Linden

Well, some women don’t. But their babies deserve to suffer from dehydration, don’t they, Brooke? Some babies are just meant to die, aren’t they, Brooke? We need to keep the C-section rate at below 5% at any cost, don’t we, Brooke?
You’re both ignorant and heartless.

demodocus

i made lots lots, eventually. Didn’t help the poor kid getting a thimbleful for a meal his first week.

MI Dawn

Brooke: as nurse for many years and a midwife, I want to say yes, not all women produce colostrum right after birth. Some never do. Some do in a few days. Some do before birth. Guess what? WOMEN ARE NOT STEPFORD WIVES!!! Bodies aren’t perfect.

KeeperOfTheBooks

Something to consider, oh ye breast-at-all-costs types:
I had a sufficiently awful experience trying to BF my first kid that I’m not risking it again with the next. It’s not an option. However, my one good breastfeeding memory with DD was nursing her on the OR table while my OB closed me up. There was no pressure, no worry yet about my milk supply, just lots of lovely getting-to-know-you snuggles while she got a nice dose of colostrum. I’d kind of like to do that again this time–nurse once or twice to give baby some colostrum before switching exclusively to formula, especially, if baby’s okay, right after delivery.
The thing is, doing so would mean probably getting a lot of pressure and nastiness from the lactation consultants to keep going, just-one-more-feed, the lot, instead of, hopefully, being left the hell alone to make my own decisions when I’m physically and emotionally wrung out after labor/a RCS/both. As a result, baby is less likely to get even colostrum.
Consider that the rhetoric and pressure might actually *keep* some moms from breastfeeding because they simply aren’t up to engaging in an ever-higher-stakes-and-pressure poker game with the lactation consultants. (I did see an idea here which I rather liked, which is to nurse when no one else is in the room so that I won’t get jumped on by the staff. Sad, no?)

J.B.

I made tons of milk, and it came in within 36 hours for the second kid. I really wish I had brought or requested one bottle because it would have bought me a couple of hours of sleep around hour 20 when she was getting mad. I did have my mom bring some ebil pacis because both my kids had mega suck drives. I called the little one a booby seeking missle. She nursed just fine. We did introduce one nighttime bottle, used formula in it beginning at 6 months. Happy mommy happy baby. Who has an excellent sense of self. And very strong will : )

OttawaAlison

Oh hey Brooke, haven’t seen you coming on and saying how wrong she is and how wrong we all are in a few posts.
Whatever. Seriously, my almost 10 year old (very healthy to boot) couldn’t care less that she wasn’t exclusively breastfed. She did complain when I refused to buy formula and was breastfeeding her 24/7 trying to sustain her on me alone. It didn’t work, she lost weight. Thankfully I trusted my gut and took advice from LCs at 2 weeks to supplement.

sdsures

Your pointless post proves what?

Stephanie

I never made any colostrum with either baby. My milk didn’t come in until day 7 with my first and day 5 with the second. My sons would have died without formula. Not everyone has the same experience as you.

LibrarianSarah

Unless your name is really Chaka Kahn or Whitney Houston, you are not every woman.

Monkey Professor for a Head

I find it strange that most medical fields are trying to stamp out paternalism, and yet BFHI seems to run on it. We can’t have these silly women making choices that we don’t approve of. We must put as many barriers as possible between them and formula, and feed them exaggerated information about the glories of breastfeeding, or else they might not do what we want them to do.

Give parents accurate information and let them make their own decisions.

Who?

Did you hear The Health Report this week about how to feed babies to help avoid allergies to nut, egg and ?seafood?

The child feeding expert, and even the otherwise delightful Dr Norman Swan, were both droning on about the importance of breastfeeding and what to do if you ‘need’ to use formula.

CSN0116

Doesn’t breastfeeding increase allergy risk?

Who?

No idea-perhaps it’s a confounder issue.

The new guidelines here are to start the tricky foods no later than six months-so if you’re fully breastfeeding for more time than that, you miss the window to prep the body against the allergy.

Dr Kitty

I never really needed an excuse, but “reducing allergy risk” is an excellent reason to give for eating Snickers, halva, houmus and Nutella while breastfeeding…

Megan

IIRC allergy risk was increased with breastfeeding in the discordant sib study. Though it might’ve been PROBIT. I can’t remember off the top of my head and I’m not at work to be able to check.

CSN0116

It was PROBIT (others as well, I believe).

The “delay solids and common allergy foods, wait strike that” is one of the faster about face turns I’ve seen as of lately. Therefore I’m guessing the original evidence used to push for delaying foods was based on minimal, shakey findings, at best.

Anne Catherine

There are quite a few studies that have found an increase in eczema and food allergies with exclusive breastfeeding–below are a few:

I’ve read somewhere where Dr Amy says that the patriarchy (old. white, male obstetricians) has been replaced by the matriarchy (protectors of normal birth, lactivists and attachment parenting gurus).
Not her exact words but along those lines. Very accurate in my view.

Monkey Professor for a Head

Exactly. Maternalism seems to be the exact same thing as paternalism to me, just packaged differently.

Chi

What’s worse is that it’s packaged much more attractively, using words like ’empowerment’, ‘trust’, ‘natural’, to disguise how utterly unempowering and anti-feminist it truly is.

sdsures

I have come to hate, HATE the word “empowerment” because of this.

Puffin

Medical students matching into OB/Gyn are overwhelmingly female now. The retiring generation is around 80%+ male, depending on location, while the incoming generation in North America is nearly 90% female. It’s crazy how fast the shift has happened. And there’s a hell of a lot of ‘my way is the only way’ and ‘natural is always better’ types going into OB. OB/Gyn is a hotbed of matriarchal medicine, for sure. Of course there’s plenty of fabulous examples of clinicians who don’t fit this description at all, but I’ve seen enough of it that I requested a male OB for this pregnancy.

SporkParade

Absolutely. My mother told me as a young girl that my grandmother was killed by the attitude that women are too flighty and hysterical to know when something is wrong with their own bodies. She also reassured me that this attitude has all but disappeared. It was only when I took a natural childbirth class and was abused by the hospital nurses in the name of exclusive breastfeeding that I realized how wrong she was. Ironically, it was only my male OB who took my medical concerns and my complaints about the nurses seriously.

Amy M

Haven’t been able to read comments (no time) so sorry if this is a repeat: I think the idea of bringing formula to the hospital is great, and I would suggest getting those ready-to-feed nursettes or whatever they call them. You wouldn’t even have to worry about a bottle, let alone mixing up powder, with those. Super easy.

Sarah S

Just be warned some babies don’t tolerate them well. They made both my babies really pukey, even though the ready to use 8 oz bottles were fine.

Kelly

The nipples are so fast on those things. When I got home, I just put it in a bottle with a much slower nipple.

Kelly

OT: Went to the orthopedic doctor and they took another x-ray and they think she may have hemihypertrophy. We have to go to genetics to take a blood sample and confirm it. Unfortunately, this would be worse than lymphedema but as of right now I am doing ok. Normally, it takes me a few days to process bad things and I may be a wreck tomorrow. We won’t know for quite a while so we just have to sit and wait.

momofone

Thinking about you and hoping for quick answers. Waiting is so hard.

demodocus

*hug*

BeatriceC

Hugs. If you need to chat with somebody who’s up to her eyeballs in kids’ medical issues, so btdt, though with different stuff, feel free to send me a message (I can give you an email or my Facebook name for messenger.)

Kelly

Thanks. I think I will need that once we get the diagnoses.

Gene

Are they thinking beckwith weiderman syndrome?

Kelly

Yes. Do you know anything about it? I have researched both but she does not seem to have signs of the syndrome besides having a lot of birthmarks and the bigger and longer leg. Can she have the hemihypertrophy without the syndrome?

sdsures

*hugs*

TiredofthisBFHIcrapalready

We are just starting to go baby-friendly at our hospital. Our formula isn’t locked up yet. As of now, we just still document that a mom requested formula or requested to send the baby to the nursery. But I hear horror stories about BFH that have formula locked in a pyxis machine to prevent the nurses from giving formula when it’s not medically necessary and without a doctor’s order. And I can tell you, our experienced nurses KNOW when a baby needs formula. We don’t need a doctor to tell us this. Then, we have our few pediatricians who don’t ever think formula is necessary in the hospital. I bet she sees LOTS of dehydrated and jaundice kids in her newborn appointments! , They can keep track of who’s handing it the formula this way also. I hope our formula stays easily accessible, but I’m not betting on it! As of now, we still have a nursery that most of our moms use EVERY night. I’ll tell you the truth, we are absolutely worried about our jobs. We are part of a larger health system (our other hospitals are designated as baby-friendly). We’ve heard the stories from nurses who’ve worked at the other hospitals about how nurses were getting in trouble for using the nursery when it wasn’t medically necessary, and giving formula when it wasn’t medically necessary. I just don’t know how far some of these hospitals might take this whole thing? Bringing formula is a GREAT idea. Bring some ready to feed bottles. If you’re taking the initiative to give formula, the RNs would be much less afraid to hand it to you without a “medical need” (10% or more weight loss, jaundice, not enough wet diapers, etc. I think it absolute stinks to have to resort to this! Or else, demand the formula! Ask several times! The nurse can chart this, that you’ve asked several times,… “that you supplemented with all your babies until your milk came in, etc, or that you’ve decided to breast AND bottle feed. Heck, tell her you’re now going to breast AND bottle feed. You have the right to bottle feed! Or tell her you’ve changed your mind and aren’t going to breastfeed anymore! It’s your right! PLUS, it will screw up their exclusive breastfeeding numbers and continue to prove that the BFHI does work! Bring one of your forms stating that the staff is choosing to starve your baby! They’ll give your formula! I guarantee it! You don’t just get the free diaper bag with formula in it anymore either! So, yes be prepared with formula at home too! We would GLADLY give you formula! But I think some BFH make it harder than others for nurses to just give it out unless it’s medically necessary! Even a few years ago, it was VERY common for women to “top their babies off” with formula because they wanted to, or send the babies to the nursery with one bottle overnight, or two bottles overnight. No one even batted an eyelid! Our patients were happy. Our babies were happy. Our moms slept. And yes, many of our moms STILL successfully breastfed! Now our LCs have placed signs in our patients’ rooms, guilting them into rooming-in and not giving any formula unless medically necessary! Our nurses have NOTHING to do with this sign! We were so angry when they appeared! There are barriers for nurses in BFH. But, we will definitely work with you! There are ways around this! And my theory is all of this will eventually go away, just like the 24hr discharges did. Keep helping us bring attention to how ridiculous and dangerous BFH can be! It just may take some time for our upper managers to stop buying “the LC Kool-Aid”! Hospitals pay $11,000 to be evaluated also. So how hospitals believe this is a good idea in the first place is beyond me! These lactivists can be VERY convincing! I’ve seen them in action! They infuriate me! We will fight for you though! Just work with us a little! Thank you!

AA

Perhaps some RNs at a BFHI hospital can respond, but my interpretation is that some hospitals won’t provide formula without a provider’s order, AND that formula can’t be a default “as needed” order for all patients. So that means, you as a RN of course, has to page the attending or resident and wait for them to sign the order…that can be a long time. Then go get it from Pyxis or a similar system.

TiredofthisBFHIcraplaready

Not sure! I’ve heard varying degrees of insanity. Not sure how insane ours will eventually be. We’re being told that no mother will be stopped from giving formula if she wants to formula feed. I’ve heard about a hospital close to us, but in another state, that REQUIRES your pediatrician to give you a script from his office to BRING with you to the hospital to get formula in this hospital! Can u say INSANITY? Know a relative of a friend who delivered there and gave them hell! We also know when our in house docs want formula. And if we weren’t sure, no problem to page them. They’d gladly give us the order. Most of our docs have no prob with formula. There’s one that I’d always ask because she’s nuts. I’d page her in the middle of the night just to bug her if I had to! I’ve heard that some BFH aren’t all that crazy. I’ve also heard that some of them do what they need to do for the eval, then go back to functioning relatively normally….using the nursery again, etc. God help the moms/babies who deliver during the eval period! So not quite sure to answer your question. We’re kind of still in the dark about how ours will work. But, our crazy LC throws away OUR pacifiers that she sees in BRF baby’s cribs! She’s nuts! You can’t go wrong with bringing your own binky and some ready to feed formula.

SporkParade

Maybe this is just my damage, but I’m not reassured that they’re telling you that no mother will be stopped from giving formula if she wants to formula feed. Where I gave birth, that was also the case, but if you were breastfeeding and wanted to consider supplementing, good luck getting any of the nurses to discuss it with you.

StephanieA

Yeah. We have a feeding contract mom has to sign on admission- choices are exclude BF, combo feeding, or EFF. You’re better off signing for combo feeding because you’re much likely to be hassled for requesting a bottle. Moms who sign for EBF are often talked out of their request.

demodocus

reminds me of when i accidentally lost my lunch box at a rather crunchy coffee shop. i can understand why they tossed my sandwich, but not my unopened little bottle of soda. (a special treat; i was sad)

KeeperOfTheBooks

I understand your sorrow. 🙁 Under ordinary (read: non-pregnant) circumstances, I don’t really care very much about soda. I’ll have one perhaps once a month, but don’t keep them in the house. The one consistent craving from DD’s pregnancy to this one has been for icy-cold cokes. I’d have been sad, too!

demodocus

Oh, this was pre-babies but that’s about my rate too.

Megan

What is it about soda during pregnancy?? I normally couldn’t care less about soda and never drink it but when I’m pregnant, nothing tastes as good as an ice cold root beer or orange soda (I can never have caffeine while pregnant or I’d probably have an occasional coke or Dr Pepper too).

KeeperOfTheBooks

For me, I wonder if it’s partly an association thing; when I had 24/7 nausea with DD for the first few months, an ice-cold coke or orange soda, sipped on all day, was the only thing that kept the nausea somewhat at bay. (Given that I lost 10 pounds in the first few months, I don’t think I was overdoing it. ;)) So, perhaps partly a comfort thing, partly a replacement for my nightly beer/glass of wine that isn’t an option once pregnant.

Bombshellrisa

OMG root beer was never as amazing as when I was pregnant with my son. I remember we were driving to lunch after our ultrasound and I made my husband turn around so we could go to a place with root beer floats in icy mugs. I remember swooning, the root beer was so good.

KeeperOfTheBooks

Your insights regarding the evaluation period are interesting, and jive with my admittedly very limited ones from when I had DD. My hospital was, at the time, gunning for BFH status, which they received a few months ago. As I’m pregnant and planning on FF, this did *not* exactly fill me with warm, fuzzy feelings, especially given that my experience with DD was pretty horrible.
However, when I called L&D and spoke to a charge nurse about what to expect, it sounded fairly rational: they have LCs available 24/7 if you want to talk to one, but if you want to FF, they don’t give you a hard time and have “plenty of formula.” (I’m still bringing some RTF bottles–worst case scenario, I bring them home with me again.) They encourage, but do not require, rooming in, and if you need a break, just tell your nurse and she’ll make sure you get one. If you aren’t up to aspects of baby care (one of my concerns, in case I had a RCS, DH had to stay with DD, and I’d be unable to get out of bed for a day), they’ll do that for you. Etc. I’m cautiously optimistic for a better go-round this time, but am going in prepared in case it’s otherwise.

StephanieA

I work at a BFH. We don’t lock our formula. We can give formula to moms who request it, with the exception of one doctor who will flip his shit if we give it without calling him first (don’t get me started on this particular doctor). Whenever moms request formula they have to sign a form basically informing them of the ‘dangers’ of it. Even though our formula isn’t locked, the mentality of breast is best is very much there. I judiciously give formula when asked, but I know other nurses will try to talk moms out of it. It’s so patronizing and infuriating.

TiredofthisBFHIcrapalready

Well, I can only hope that our hospital is more like yours than like some of the other horror hospitals that I’ve heard about! So many people are making SUCH good points in this comments section! In my experience, many times the infant who aren’t breastfeeding well initially need those extra calories from formula to either get their blood sugar up, recover from a stressful labor, etc. Pretending that every Mom is going to make enough milk, that every Mom has enough colostrum available immediately, and that every baby can breastfeed effectively from birth does NOT help these newborns. If it’s a term kid who’s just sleepy, but has no other problems, fine, the kid probably doesn’t formula. He/she may just need to wake up more, and might do just fine. But unfortunately, we’ve now let some VERY CRAZY people into these lactation consultant jobs. Many of them don’t even have a medical background at all. And they’re just here to push their own agendas. They know nothing about newborns and newborn care other than the babies they physically gave birth to, and probably breastfed without difficulty. Hence the reason they’ve now entered these lactation careers. They’re simply moms that loved breastfeeding and believe that everyone else should and can breastfeed too. These idiots CERTAINLY KNOW nothing about at risk (pre-term or GDM) newborns! These women are just like Brooke on here who likes to comment! They assume everyone’s body will function like theirs does and did! We have one LC who argues with the Neonatologists in front of patients. This makes our job so difficult, especially when you’re dealing with a patient who has the same mentality as this idiot LC! She’s out of control! Some of our infants have to be readmitted because she gives completely inaccurate advice bases on bogus research! Luckily it’s only a small percentage of our patients who believe her. And luckily she’s too lazy to see most of our patients. She’s in her office working on Baby Friendly stuff most of the time. Yes, the magical world of Baby Friendly where there’s plenty of colostrum for everyone! We have had patients and FOBs throw this LC out of their rooms. I really hope that patients start complaining about her. Our nurses fight with this LC CONSTANTLY! And our manager has to talk to her frequently about basically practicing outside the scope of her practice! I’m sorry, Drs orders are what we use to practice nursing. We don’t just listen to a mother who loved breastfeeding! She needs to back the hell off! Most of us RNs will fight really hard for our moms! But unfortunately it’s a loosing battle for us right now!

The paternalism or maternalism of doctors treating nurses like they’re idiots is also part of the problem.

Gatita

Having easy access to formula and pacifiers puts mothers, not lactation professionals, in charge of both babies and their own bodies. It eliminates the ability of hospital personnel to pressure and humiliate women into fulfilling the hospital agenda and leaves personal decisions to the person actually affected by them, the mother.

The Oscars, particularly the response to Patricia Arquette’s call to fight sexism during her acceptance speech.

Lindsay

I gave birth at a BFH. It was awful, and I would NOT do it again. I ended up all alone and in terrible pain with a newborn. I was too afraid to take anything stronger than ibuprofen for my pain. I nearly smothered my daughter when I fell asleep feeding her and I spent most of my stay crying because I was exhausted and there was nowhere safe for my baby to go.

I could go on and on about my stay (and have), but more to the point: one nurse *did* offer formula when my daughter kept screaming. I refused and was annoyed at the time that she’d made the suggestion, because I’d bought into the whole breast is best/no formula/need to establish breastfeeding relationship/nipple confusion thing.

Now, I’m thankful that she was concerned enough for my daughter’s well-being to break the rules. Thankfully, my daughter probably didn’t really need formula since the crying stopped after her first BM, she never lost more than 3% of her body weight and she had already started regaining by the time we left the hospital. Not too surprising as I had been leaking colostrum for months.

I would have been enraged, horrified and so guilty if I had injured my daughter because I was trying to do what I’d been told was best for her.

Lisa

They didn’t give you a bassinet for the baby? That’s really weird. The nurses at every hospital I have given birth in (3 in three different big cities in the us) have emphasized that sleeping with the baby is dangerous. I’m sorry you had such a hard time!

Lindsay

There was a bassinet.

Inmara

Bassinets are stupid, they’re so high that it’s easy for nurses to check baby in there, but a nightmare to soothe or pick up baby when you’re in bed. I ended up bedsharing for the same reason – baby wouldn’t stop screaming at night when put in bassinet and I was too sore to quickly get up from bed.

KeeperOfTheBooks

What Inmara said. Baby wouldn’t stop crying in the bassinet, and in my case, I couldn’t put baby in the bassinet from my bed, but also couldn’t safely get out of bed while holding baby.
A redesigned bassinet, one low enough that mom could reach it (and the diaper etc supply drawer) from the bed and whose wheels locked, would be brilliant. Some babies will calm down in the bassinet if you can just pat them a bit, but the bassinets were high enough at mine that if baby was in it, I couldn’t reach her at all. My nurses also emphasized that bedsharing is a really bad idea, which, of course, it is, but gave me no solution to avoid it.

Megan

What can’t they make them adjustable height with the lever to move up/down on the push handle?? It wouldn’t be that hard to engineer. And wheel locks are a no brainer.

Sort of, but ideally with a barrier between mom and baby so that mom would be much less likely to accidentally roll over baby or push blankets/pillows onto baby while sleeping. The barrier would also allow for the bassinet to be used as many are now, for transporting baby safely through the hall for checks or procedures. And then if it had some sort of side arms/pieces that included a drawer for diapers, wipes, a change of onesie, formula, et all, that would be brilliant!

Lindsay

The intention was never to sleep with her. I hadn’t slept for more than a few minutes in days, so it was inevitable that I’d fall asleep whenever things were quiet for a few minutes. What I really needed was someone to watch her and tend to her needs while I slept for a few hours so that I wasn’t tired enough to nod off mid-conversation or with a baby in my arms.

Fleur

My baby daughter screamed the entire time I was on the hospital ward, even though I breastfed (on the midwives’ instructions) until my nipples bled. I said “I don’t think she’s getting anything out of my breasts”. They said “as long as she’s having wet nappies, she’s getting something”. I said “I haven’t seen any wet nappies”. They said “ah, well, she wouldn’t look so happy if she was starving hungry”. I said “but she’s screamed for hours!” They said “oh, she’s just trying to get a cuddle. Babies can be very manipulative”. Thank God for the one decent midwife (there’s one of those in a lot of these stories) who gave me a few mls of formula, and for my lovely mother who encouraged me to top up as soon as I was discharged.

Sean Jungian

Oh ffs with the “babies are manipulative” horse dookie. I would like to punch everyone who has ever said that to me – it’s a newborn, any manipulation they’re doing is because they need something!

BeatriceC

Last I checked newborn babies were incapable of the higher cognition required for actual manipulation.

MI Dawn

Exactly! And if any nurse or LC had the nerve to say that to me, I would have ripped them a new one. However, since I am well above childbearing age, I’ll have to keep it in reserve if either of my daughters ever have babies. (evil grin…)

BeatriceC

This is about my attitude, though with my step-daughters and my future daughters-in-law. Though my one woo-obsessed step-daughter might be a lost cause.

Valerie

Right? Crying when upset (be it hungry, uncomfortable, or just overwhelmed) doesn’t require any intent. They don’t even have to want to be picked up or understand that that’s an option.

Is my fire alarm manipulating me when it chirps ever 30 seconds? No. It just needs it’s batteries replaced, and the system is designed so that it’s tough to accidentally neglect critical inputs. Same with babies.

LaMont

Um, it’s my understanding that fetuses and newborns can do things like tell people to go to Bali, decide to turn breech or take forever in labor just to test mom’s resolve, and then proceed to impishly fail to thrive just to see if mom will be tempted to use formula. Babies are tricky little buggers sometimes.

Sean Jungian

Oh, and they communicate telepathically with dolphins, too, right? 😉

Sean Jungian

It really trips my switch, I used to hear it quite a bit. I, too, am past childbearing age myself, but I will be advocating for any grandchildren or great-nieces/nephews coming up.

It particularly chaps me because some fundamentalist religions like to use it as a justification for spanking – yes, spanking infants. Nice.

I’m not going to get into a spanking vs. non-spanking thing here but when they’re talking about infants/children under a year, I think that custom could safely be retired.

BeatriceC

And don’t even get me started on “blanket training” a la the quiverfull movement.

Valerie

I had to look that up. Yikes.

BeatriceC

Enough to give a decent person nightmares, eh?

Valerie

It sounds like a psychology experiment from before we had institutional review boards.

Who?

Wow. Imagine having the brain that dreamt that up. And imagine having the temperament to undertake it.

Azuran

Why buy a baby park when you can put a blanket on the ground and beat the crap out of your baby.

Gatita

Holy shit! That’s like Pavlov’s wet dream. My God.

Bombshellrisa

My parents did that stuff with me, I decided that it might be more convenient to have a timid little soul who is afraid to leave the blanket for fear of being smacked and scolded but it’s not good for the kid at all. I have made little quiet pages and I carry a few things in my bag that can entertain a little one if we need to wait somewhere but the blanket thing–NEVER.

Well, the baby is manipulating you – but to try and get food, not cuddles.

Which seems pretty self-obvious, actually. If the kid wanted cuddles, the continual breastfeeding would take of that at the same time.

demodocus

I supplemented, because my milk took most of a week to come in, and continued for another week or two because of the deep cracks and bleeding. He was ebf after that until we started solids (other than my blood)

Old Lady

I did this with my newborn and it worked well for me. I don’t know if they would have given me a hard time but it was also useful because I didn’t have to wait for the nurse to feed her. They did give us some formula after we had used some of our own, they offered it in fact. At my hospital they keep track of what the baby is eating, the nurse was entering type of formula and amount in the computer. A few years back I had been to the same hospital for my first birth before they went BFHI and they helped us supplement when the babies still seemed hungry and unsettled about a day out. I don’t remember it super clearly, I just remember panicking that they weren’t getting enough food. This time around I was a much more confident and experienced mother. I offered formula but she didn’t like it much and we came to the conclusion she kept nursing for comfort so we went with pacifiers, which she spit out and we had to hold it in her mouth. If she was hungry she would let us know, she wouldn’t a accept the pacifier then. She is still like this actually. I was even able to exclusively breast feed for three weeks after giving her formula in the hospital and pacifier. The reason I started giving her bottles is that breastfeeding is very time consuming and I had to take care of the older children once husband went back to work.

Heidi_storage

I went through hours of Hell in the hospital; my son bit, not sucked (he NEVER was able to suck, but I wound up pumping for him), and he was terribly, desperately hungry. We were both screaming for hours before I begged, first for a pacifier, then for a bottle of formula. I was finally brought formula, but I had to sign the I’m-A-Bad-Mother form stating that I knew breast was best. I am still extremely angry about this, especially since a few hours later–after my baby had had some formula, no less–they weighed him and found that, oops, he’d lost 10% of his body weight in less than 24 hours.

Next time around, I will still be signing the form, but I will be asking for formula sooner rather than later, and I will be talking to the hospital about not humiliating new mothers and starving their children.

Incidentally, aside from this caveat, everyone at the hospital was wonderful. They were, I think, just constrained by this evil policy.

AA

Out of sheer pettiness, I’d probably sign the form but write in that you’re signing the form out of duress to obtain your child adequate nutrition and that by signing, you do not agree with the statements on the form.

BeatriceC

I’m with AA. I’d write “I refuse to starve my baby so I’m making sure he’s fed, even if my breasts aren’t producing milk just yet. I am acknowledging by signing this form that this hospital is neglectful by refusing to provide food for my baby when it is clear he is starving.

I’d condense it to “My baby is hungry and my milk isn’t in. Fuck this shit and give me formula before I call the patient ombudsman.”

Heidi_storage

You know, I think I like this version best, though Mel’s is undeniably pithier and closer to my actual sentiments; B’s verbiage has an air of pseudopoliteness that I think works better for passive aggression.

CSN0116

I’d one up this approach and falsify that I was an exclusively formula feeding mom upon intake. When you state that under no circumstance you will be breast feeding, you get left alone rather quickly.

This way you have bottles of formula brought to you, but can nurse your baby in secrecy and privacy without pressure and bullying tactics. If I needed lactation assistance, I wouldn’t want it from a hospital LC anyway. I’d pay for an independent one to come visit me inpaitent. But seeing on how fast most moms are discharged, I’d just wait and get the assistance at the pedicatrician’s office after I leave.

trashpanda

Really, you got left alone? They knew I was formula feeding, and I had several nurses and 2 LCs “accidentally” come into my room but since they were there they acted like I was 12 and stupid and had to be informed about breastfeeding. They never got too far, as I started yelling at them pretty quickly.

Upon discharge I wrote and called several people at the hospital, the big corp that owns them and my insurance company in case they tried to charge them for LC services I refused. I actually got an encouraging phone call, and met with one of the hospital bigwigs in person, and he was actually taking some of his own notes (he had his admin assistant there for notes).

CSN0116

Oh, I get left the eff alone. I’m a lost cause and already hurting any numbers they’re trying to bolster, so they have bigger fish to fry.

Surprised that they still considered you worth pursuing.

trashpanda

I was 30 but looked like some teen mom. I’m surprised my threats of physical violence to nurse #1 didn’t keep the next ones out. I wasn’t kind, I had my iPhone in it’s Otterbox ready to chuck and I have pitched softball for years. I don’t miss.

CSN0116

I like you.

BeatriceC

I’ve told this story before, but it’s relevant here. I used to teach middle school. One of my 7th graders had her second child while she was my student. She was bullied so horribly by nurses and lactation consultants trying to force her to breastfeed that she actually contemplated suicide. Come on! This is a 14 year old girl with an 18 month old and a newborn, trying to stay in school. Give the kid a break. She needs one. Seriously. Thankfully she held on until discharge and came to school before she was scheduled to come back and confided in our counselor. The faculty all pulled together to help her through. Last I checked she was graduating with an AA from a community college and heading off to a 4 year university. And to think that some bully nurses nearly drove her to suicide and left two babies motherless.

LaMont

I can’t *imagine* how real medical professionals could view the obvious, serious effects of *being born to a 14-year-old with another child already* who will have major difficulty with her education (and let’s be real, earning potential) as less serious than the non-existent risks of formula feeding. This is horrifying, both for mother and children. How in the world is this considered best practice??

BeatriceC

Oh, the strikes against that poor girl were overwhelming. She was being raised by a grandmother because both parents were in jail, in one of the most violent neighborhoods in the entire United States. The fact that she graduated high school was a major accomplishment, let alone got a AA (two year degree, for the people outside the US), and was attempting to start at 4 year university. It took her longer than average, but she did it. She put herself in a position to be far better off than generations of her family before her, even though she did have those babies so incredibly young. She’s one of my all time favorite students, and sometimes I just sit back amazed at her will to Do Better.

LaMont

It is definitely amazing – as someone who was given every advantage you can think of and then some, I am in serious awe of people who can look at a really rough situation and fight their way into a better one. I have no way of internalizing what that’s really like, but as a person with (I flatter myself) some sympathy, I like to think that I wouldn’t actively approach someone in a seriously difficult situation and go “hey, let’s make it MORE difficult”. Jesus.

Jules B

That is an excellent strategy actually. I think that would have definitely worked for me in the hospital I was at; most of the attention while there wasn’t to really check on my well-being or the baby’s, but to harangue me about breast-feeding. Like, forcing me to sit a certain way in the chair (which I found very uncomfy) and making sure I was writing everything down (when I fed/wet and dirty diapers) and of course, coming in to wake me up every two hours to try and nurse. I really felt at the time that if they’d just left me the eff alone for two minutes, I could have figured out the best nursing position for myself and been way more relaxed, not like I was on stage being judged on everything I did.

I’d go a step further if the woman involved is up to it. Ask for formula first. The baby is still a patient and the hospital is still obligated to care for said baby. Refusing feeds is neglect. So I’d ask first, then document the refusal every time. Then I’d feed my own formula so the baby doesn’t suffer. After discharge, I’d file formal neglect complaints with the hospital, the appropriate governing boards, and my insurance company. If enough women started filing formal complaints, maybe they will pay attention.

FormerPhysicist

I love the idea, but I couldn’t have done it immediately post-partum. Heck, I didn’t manage to contest the out-of-network bill for the anesthesiologist (excuse me, my doctor and hospital were in-network, how do I know to interview everyone that comes in the room!).

BeatriceC

That’s why I qualified with “if the woman involved is up to it”. I couldn’t have done something like that with my first, but I could have with my second (sort of) and definitely with my third. Age and experience changes things.

Cartman36

Complaints don’t have to be filled immediately. It’s not unreasonable to file a complaint 90 days later.

BeatriceC

True, but the confrontation part where you verify with the nurse that they are refusing to provide food for a patient in order to to document it would be pretty difficult for a lot of people on a good day, let along right after they’ve given birth.

Charybdis

Yeah, I’m pretty sure that if you phrased it that way: “So you, an RN, are refusing to provide food for a newborn patient? Just so I’m clear on what is going on. So, if you are refusing to provide formula for my baby, you won’t mind signing this refusal form, then.” they might back off their ultimatum a bit.

It’s not like you are asking them to actually feed the baby, you just want some formula so YOU can feed them. And they have the RTF formula on hand.

KeeperOfTheBooks

Absolutely. When I was really, really into the woo, I planned to become a CPM, and shadowed one for a day. While a lot of what went on that day boggles my mind now, one thing that CPM said which was absolutely dead-on was something like “during and after labor, moms often feel really vulnerable, and, frankly, want their own mom or a substitute mom (close friend, sister, nurse, doula, etc) to be there to be loving and supportive. They shouldn’t have to worry or stress; they should be able to let “mom” handle everything, like when she was a little girl.”
Of course, there are some issues with this (neither you nor I, for example, would probably want our moms within a thousand miles of us while we gave birth!), but I think the general idea was sound. When I’d had DD, I wanted the nurses to be kind of substitute moms: take care of us, tell me I was doing okay, help me learn how to do this whole new mom thing, etc. There was no way I was mentally or emotionally up to challenging them on, well, anything. This time will be a bit different because of my past experiences, but dealing with things the second time is totally different from the first time someone hands you a baby and says “congratulations!”

BeatriceC

I’m thinking more and more of becoming a doula, but billing myself as a science based doula. I want to offer postpartum support, but it would be a struggle to stay within my scope of practice. I want to offer things like overnight support so moms can sleep (sit in the room and watch baby while mom sleeps, then hand baby to her for feeds, and put baby back in bassinet when done, help change diapers, watch baby so mom can shower, etc). I’m not all that sure how to go about doing that though. My youngest kid will be 14 one week from today. I’m almost done raising kids.

KeeperOfTheBooks

There is a doula in my area who does both labor/delivery and postpartum doula-ing, and overnight support is one of the services she offers. Interestingly, she seems less woo-y than many, in that she explicitly mentions help with bottle feeding as one of her services as well as the more standard breastfeeding support.
She also charges a bit over a grand to attend a birth, though, and $30/hour postpartum, with overnight services starting at $300/night, IIRC. Pricey, particularly the birth/overnight services, but I imagine she must have people willing to pay those rates or she wouldn’t charge them.

KeeperOfTheBooks

OT, but I recently read that almost 50% of the hospitals in my state don’t employ in-network doctors. This makes me see more than a little red, as my insurance plan, while generally excellent and far cheaper than most due to DH’s work, is an in-network only plan. If I go to the ER and it’s in-network, I pay all of $100. Yes, that is obnoxiously cheap! However, if the doctor isn’t in-network, then I’m responsible for his portion of the bill. Apparently I’m supposed to say, “Excuse me, doc, I know you’re assessing whether it’s possible to reattach my foot, but I was wondering if you take Insurance Plan XYZ, and if you don’t, could you back away from the table and call a doc who does? Thanks so much, and now if you’ll excuse me, I’ll go back to my regularly-scheduled ‘MY FOOT JUST GOT AMPUTATED’ screaming. Thanks!”

Who?

We have a similar thing in Australia, where private health insurance covers some, but not all, doctor and hospital expenses.

When my daughter broke her arm last year, the emergency physician referred us to a surgeon. The surgeon billed around $4000 for the procedure, of which our private health fund covered about $200. When I asked them what that was about, they said (apparently in all seriousness) that I should have sat in Emergency and looked up, using the app on my phone, whether the surgeon was a doctor who regularly offered no gap surgery to members of our health fund.

Her surgery was complex, and long-so even if he was usually a ‘no gap’ surgeon, there is no guarantee he would be in her case. I thought the idea of insurance was to get the doctor you wanted. My bad, obviously.

As my gp friend pointed out, even if the surgeon was a ‘no gap’ kind of fella, there’s no guarantee the anaesthetist would be.

Grr. Not at doctors, at health insurers.

KeeperOfTheBooks

The sheer nerve of both some health insurers and hospital admins absolutely blows my mind. The docs generally aren’t at fault, though I have run into one practice that was decidedly shady in the way it was run. (Read: not getting patient permission to do extensive testing, sending the samples to a lab not covered by insurance, and then acting shocked when the patient was bloody furious over a giant and unforeseen bill that could have been avoided by simply sending the sample to an insurance-approved lab, which would have happened if they’d gotten permission in the first place…)

MI Dawn

I’ve had doctors try to do that to me, also. I make sure I state “all labs must be sent to XXX lab per my insurance” when the office draws the blood and ask for that to be noted on my chart. That way they can’t claim they “didn’t know”. If they refuse, I take the lab slip and go to the lab.

IF the doctor can give me a good reason to sent to YYY lab – i.e. “this is something important and only YYY lab does it and this is why we need to have it done” I might approve it. But doing it without my permission is a BAD move….

KeeperOfTheBooks

In my case, I was pregnant and sent to a MFM doc. What’s the first thing any pregnant woman does on walking into a doctor’s office? Pee in a cup, right? I figured that, like at my doctor’s office, they were dipping for ketones/protein/evidence of a UTI. No problem.
Instead, they sent it out for a complete drug/tox screen (nope, not a concern of my OB’s–believe me, I checked to make sure he didn’t think I was taking anything!) plus some other workups. If they’d told me that office procedure was a drug screen, I’d have been mildly annoyed, but said “okay, just please send it to a lab covered by my insurance.” Instead, I got a massive bill a couple of months later because they apparently like to spring this sort of thing on their patients unannounced. I was Not Happy.

MI Dawn

I wouldn’t have been, either!

MI Dawn

I can’t speak for all states, only NJ. But an ER visit for an emergency will be covered 100% (less any deductible/copay) whether the doctors are in-network or out. You might have to call the insurance company and protest a bit, but state regulations do require that for true emergencies (i.e. foot amputation but not “I’ve had this cold for 2 days). Unfortunately, until people protest enough about in-network hospitals allowing out-of-network MD groups to be employees, it’ll continue.

Thus endeth my insurance rant (yes, I DO work for the dark side of the force, why do you ask?)

KeeperOfTheBooks

That’s a rather interesting point, thanks!. DH and I are fortunate enough to be in a financial position where we could feasibly tell a hospital/insurance company what they could go do to themselves if they tried something like that, but we’re the exception, not the rule: most people aren’t.
We also reserve, as you say, ERs for actual emergencies–like, the only times I’ve gone there have been heavy bleeding during pregnancy on a holiday weekend and when my regular doc was worried enough, also on a weekend, to say “you need a CAT scan to rule out a tumor/stroke/aneurism, get thee to the nearest ER,” which would hopefully help with whatever appeals process we might need to pursue. *sigh*

Sarah

Mmm, I come at this from an NHS perspective, but while I see what Dr A is saying here, equally hospitals do have an obligation to feed newborn patients if they also feed older patients. I can see that not everyone would be up to the fight immediately postpartum, but to some extent everyone bringing their own formula lets them off the hook.

BeatriceC

The fact that brining one’s own formula let’s them off the hook is exactly what I have a problem with, which is why I’d advocate for a woman to document and complain afterwards. The baby gets fed and the hospital gets held responsible. But enough women have to do it. A hospital can ignore one woman or even a handful of women, but if they start getting dozens of complaints, then they will have to pay attention.

Sarah

Yeah. Obviously women deserve to know how and why supplementing might be helpful to the breastfeeding relationship should they desire one, but we need to ensure the responsibility for this aspect of patient care doesn’t fall solely on new mothers. Hospitals shouldn’t be able to get away with ageism. I was fortunate to be given as much formula for mine as I needed, which is a shame in a way since I’m someone who actually could and would have that particular fight a few hours postpartum.

Megan

That’s probably why they didn’t fight with you.

Sarah

Heh. I delivered in a hospital with a considerable local white working class population, and they/we have some of the lowest rates of breastfeeding in the UK. I think the staff are just used to having lost that particular battle (and some of them are from that community anyway). Also one of mine was in intensive care for two days while her sugars stabilised, and in retrospect they probably weren’t too sorry I wasn’t going to risk effing her hard won stability up. She needed to have certain amounts at certain times, and breastfeeding can’t guarantee that in the way that formula can. My milk actually didn’t come in until after she was discharged, so I don’t know what they’d have done if I’d wanted to breastfeed.

KeeperOfTheBooks

There’s also an issue in that some moms may find it near-impossible to bring their own formula, or to prepare it properly at the hospital. I’m not quite sure how WIC (the program here that gets low-income caregivers free baby formula) works, but I imagine that getting started on it takes a little time, plus they give out powdered formula rather than RTF, powdered being infinitely cheaper. Since about half the babies born here are on Medicaid (public health insurance for low-income families), it seems reasonable to assume that a pretty high percentage of their parents/caregivers have a hard time affording formula. What a mess, eh?

Sarah

True. I don’t know whether all hospitals would have the facilities to prepare powdered formula either (Americans don’t have kettles as much as British people do, I’ve heard, so I’m not sure what people use).

AnnaPDE

Australia is just as tea-obsessed as Britain, and guess what they didn’t have in my maternity ward? A kettle. They had this tea-urn thingy that my husband considered not quite up to the task of sterilising dummies…
Fortunately they did have rtf bottles.

Sarah

How on earth are you supposed to manage postpartum without a brew? That’s just cruel.

guest

My hospital provided three meals a day that came at set times, and if you weren’t in your bed when they came you didn’t get one. If your labor didn’t conveniently coordinate with the meal schedule, you weren’t on the meal order list and got nothing. You got nothing if it was in the middle of the night, no matter how many hours you were awake. Tea and coffee could be had with meals, but they were awful.

I had guests bring me coffee.

KeeperOfTheBooks

No, America as a nation, sadly, doesn’t appreciate a good cuppa the way that our British cousins do. 🙁
Unless there’s something going on with the local water supply or baby is preemie/immune-compromised, most pediatricians here don’t tell parents to boil water before making bottles. However, just washing the bottles in a hospital room is near-impossible if you’re wanting to get them really clean. I suppose you could bring your own dish detergent, but then you probably couldn’t get the water hot enough (due to safety/scald concerns) to wash appropriately. *sigh*

demodocus

God, the only thing I wanted after labor was a *big* cup of tea! Fortunately, my sib found a place still open and that had acceptable tea. Loves you bestest of all, H!

KeeperOfTheBooks

Clearly, great minds work alike: I’ve packed some rather decent Earl Grey in my hospital bag this time around. Fortunately, the hospital does have a coffee shop, and even more fortunately, my best friend/birth support person appreciates tea even more than I do, so one of her “jobs” is to fetch me a giant cup of really hot water and some milk once baby’s here and everything looks good. Mmmmm.

Monkey Professor for a Head

When I did my week in the labour ward in Med school, my most important job was to fetch tea and toast for the mums after delivery.

KeeperOfTheBooks

See, hearing about tea, toast, and cake being SOP in British hospitals makes me almost want to fly over there to have my babies. So very civilized!

Who?

My friend’s son has just done his week or two in the labour ward, had much the same experience. She said his eyes were as round as saucers when he was telling her about it.

guest

My hospital had me washing breast pump parts with hand soap in a shared washroom. And this was milk pumped for preemies. It’s kind of horrifying, but nothing bad happened in our case.

Sarah

Hygienic!

Charybdis

I think we should figure out a way to design some forms that deal with this sort of thing. Nothing really fancy, but a way to record the time, date, nurse/s involved and whether or not formula was provided. And have the nurse sign the form. Have a place to note if the nurse refused to sign the form. Same thing for pacifiers.

Kind of like they have the forms that the mother has to sign stating that she has been “informed/educated” on the dangers of formula and the benefits of breastfeeding and she (the mother) still wants to formula feed/supplement each time she asks for formula.

Ooh…maybe a form of “Mother’s Chart” that she keeps that is similar to the one the hospital keeps. With easy to fill out forms, places to note things like inadequate pain relief, amount of sleep the mother has had, staff names, whether or not the mother has respite care of the nursery available, etc. Add in the contact information for the patient care advocate, patient satisfaction survey people, hospital administration and board, etc. She could then use her records to file complaints about the way she was treated as a patient, as well as the baby’s treatment. I think the mothers should be provided a copy of their chart records when they are discharged as well.

BeatriceC

I mentioned something like that a few weeks ago. Maybe I should use my copious free time (sarcasm intended) to create one and somehow get it posted as a free downloadable/printable form.

Charybdis

What else are you going to do with those 2 free minutes a day? 😛

BeatriceC

Go pee?

Charybdis

If you insist……:P

BeatriceC

lol. At the moment I’ve pawned off parrot grooming to MrC because I can’t be bothered today. Actually, the reason is that I feel like horse manure because I spent most of last night in the ER after an anaphylaxis episode to a what appears to be a new allergy to chocolate (or something in the chocolate bar). I hadn’t eaten anything in nearly 5 hours and I was in my home, which is allergen free for me, and had a small chocolate snack. Within a few minutes I was itchy, breaking out in hives and puking. I tried Benadryl and still wound up with a swelling mouth, so out came the epipen. *sigh* I have an appointment with my allergist in a couple weeks because I’ve had a few dozen incidents of unexplained itching and hives recently, but this was pretty clear. How can I live without chocolate????

Charybdis

NOOOOOOO!!!!!!! Not the chocolate! Maybe it was made in a plant/factory that makes spaghetti sauce or ketchup and you got cross-contamination from a tomato. Or something like that.

Could stress be lowering your resistance? I mean, you’ve had a couple of months of continual high stress with Everything Going Wrong All At Once and a person’s ability to cope at high speed diminishes as they get older. God knows mine has.

*please don’t let it be the chocolate, please don’t let it be the chocolate, please don’t let it be the chocolate* because carob just sucks as a substitute.

BeatriceC

I also have been recently diagnosed with mast cell activation disorder, which makes me prone to inexplicable anaphylaxis episodes and makes my reaction to existing allergens worse than they would be otherwise, so that’s an alternate explanation. And stress does increase the severity of over production of mast cells, so that could be an explanation. The ER doc said because the timeline was pretty definitive, and I’d had no other food in the 5 hours prior to the reaction, something in that chocolate bar was a safe bet as the culprit, so it was wise to simply avoid it until the proper testing could be done. My appointment with my allergist is June 7th.

MI Dawn

Crap, BeatriceC. That sucks. Though…makes me wonder about the 2 very weird allergic reactions I’ve had in my life. One while I was pregnant with D#2 – at work as an L&D nurse one night, every time I got the ultrasonic gel on my skin I broke out in localized hives. Lasted that night only.

The second time was with a medication I’d been taking – Prevacid – SEVERE hives all over my body, itching, the works. Haven’t dared that one since so don’t know if that one was a one-time thing. I was under a huge amount of stress at the time.

Something for me to consider, and I hope your allergist appointment brings you additional information.

Your continuing medical sagas (plural!) never cease to amaze. They would make an incredible novel, except that because it is real life it just sucks instead. I really, really hope it’s not the chocolate!

BeatriceC

Life handed me some challenges. Overall, I’m actually very pleased and happy with my life these days. I have three amazing kids and a wonderful life partner. My in-laws (save one, who’s kinda nuts) are wonderful. We have occasional issues, like all families, but for the most part, life is freaking fantastic.

KeeperOfTheBooks

I’m really hoping that the chocolate somehow got cross-contaminated with tomatoes (unless I’m mixing you up with someone else and tomatoes aren’t a problem for you…?). I can’t imagine how, but that would be so much nicer than a chocolate allergy!

BeatriceC

Tomatoes are the worst of my allergies, but I’m also allergic to eggplant (anaphylaxis, but slower, more minor, and requires a greater exposure) and potatoes (hives and minor wheezing, not quite anaphylaxis). See the nightshade theme? I’m not reacting to peppers just yet, but I won’t be at all surprised if that happens in the future.

One thing that might be positive for me: I found out that eggplant is a common added ingredient in some chocolates hailing from southern Europe. This was a fancy French chocolate, and my French isn’t good enough to read the label, but I’m hoping beyond hope that when I do get it translated it will turn out to be one of those.

Charybdis

Aubergine is eggplant in French and potatoes are pommes de terre.

BeatriceC

*toddles off to find the wrapper*

Thanks!

(I’ve so far been too lazy to look it up myself)

MI Dawn

So what’s the verdict? Eggplant in the chocolate? Hoping for your sake!

Weirdness note: after my recent surgery, I was closed up with superglue. The last bits came off Monday night. I covered them with 2 bandaids because two sites were a little “weepy.”, then changed them in the morning and covered them with standard bandaids – the ones I’ve used on various other body parts with no problem. Last night, took them off and have a glorious rash and broken skin at the edges of the bandage site. WTF body????

BeatriceC

Unfortunately I was not so lucky. 🙁

BeatriceC

And as for the skin reactions to adhesives, I have blisters from where the heart monitor leads were attached Monday night. Redhead. Sensitive skin. Happens every time.

MI Dawn

I’ve never had that happen with EKG leads. Sorry to read that, because it sucks. The only other time I’ve had this was after another surgery when I had steri-strips in place for a week post-op. Never with regular bandaids. Now I’m nervous and will talk to my PCP about it.

Also sorry that the issue wasn’t just eggplant…hope you don’t have to give up chocolate!

Megan

And here I was going to spend my two free minutes today designing #shitmom Tshirts to put on Cafe Press, but yours/BeatriceC’s idea seems so much more important. 🙂

Mac Sherbert

Should also make one to document when moms request epidurals and get denied. Time asked, response, etc…

BeatriceC

Honestly I like the idea of a comprehensive “mom chart”. Besides what we’ve already talked about, we could discuss difficulties in access to basic hygiene, refusal to allow support person and subsequent absence of appropriate nursing care, inadequate access to sleep due to inadequate care for the baby (i.e. well baby nursery), and I’m sure women who have given birth more recently than I have could add to that list.

KeeperOfTheBooks

The basic hygiene thing is one that, two years later, still boggles my mind. I’d get told every day that I should take a shower, but it was made clear to me that so much as leaving DD in her bassinet in my room long enough to pee was inexcusable: how was I supposed to shower, if I couldn’t even take a minute to pee?
In a shocking (major sarcasm there) turn of events, I ended up with yeast infections every-freaking-where…and yes, that included the area around my incision. Which was nearly as much fun as it sounds, let me tell you.

It’s really a catch-22, isn’t it? I had to meet a series of benchmarks (peeing successfully, then peeing a certain amount) in order to avoid having the catheter put back in, but I wasn’t supposed to “leave the baby unattended” to use the bathroom. What I ended up doing was pushing the bassinet across the room and into the bathroom doorway, then using the bathroom with the door open so that I could at least see him. Pushing that bassinet and my IV pole back and forth across that hospital room is … Not an experience I would care to repeat.

KeeperOfTheBooks

Ugh. At least my IV was disconnected by the time I was walking, but…yeah. Craziness! And under no other medical circumstances would treating a patient like this be considered acceptable!

AnnaPDE

Wut? What’s a bassinet plus the whole sleep-safe spiel for if 3 minutes of unattended peeing will kill a baby? I don’t see how it could be safe to fall asleep next to the bassinet then, either.

KeeperOfTheBooks

Now, now, mustn’t use logic!
I believe the objection behind it was at least partly that DD was crying in the bassinet. Which, I agree, wasn’t ideal, but y’know, at some point MOMMY HAS TO PEE, and I refuse to believe that being set down long enough that mommy can pee will cause a baby irrevocable damage, even if baby doesn’t particularly like being set down.

AnnaPDE

Yes, the outside world is a cruel place full of selfish peeing people, and unfortunately even babies can’t completely ignore that. (Says the commenter who couldn’t be bothered getting baby out of his carry-wrap today when she had to pee very urgently…) Even worse, babies regularly cry for reasons we can’t do anything about – what then?
There is more than just a fine line between setting a baby down for the duration of a pee and child abuse/neglect.

KeeperOfTheBooks

Indeed!
Also, while I’m not particularly fond of baby-wearing, I do remember how much I appreciated it when I travelled with a then-7-month-old and could use an airport restroom without having to either hold her, bring a stroller, or–EW!–set her down on the floor, even with a blanket between her and it. BT, DT.

guest

Did they think you weren’t going to leave the baby in a safe place to pee and shower at home? My bathroom was not big enough for a bassinet or anything, and I sure wasn’t going to lay my infant on the bathroom floor I had no time to clean.

KeeperOfTheBooks

I’ve heard/read of moms who don’t set baby down at all if it means baby will cry, because then you’re a Bad Mom. Sickeningly, and partly thanks to the hospital experience, I subscribed to that theory for a while myself. One particularly idiotic moment occurred at some ungodly hour of the morning when baby had been crying for well over an hour, and I desperately had to use the bathroom. Set baby down in a perfectly comfy, safe spot, and RAN to the bathroom sobbing “I’m so sorry, honey! I’m so sorry!”
Her sassy two-year-old self doesn’t seem to have too much damage from the incident in question, and my PPD eventually calmed down enough to the point that I realized that this wasn’t child abuse by any stretch. (Also, the fact that by the time I got back some 2 minutes later, she was cooing happily to her toes just MIGHT suggest that she was picking up on my “I NEED TO PEE” stress, no?)

guest

Yeah, I saw the AP types recommending never letting a baby cry unheld. And I said fuck that – I am a single parent with twin infants. It’s not going to happen. (I did go through a period of feeling anxious and inadequate before I figured out what bullshit that is.)

KeeperOfTheBooks

Frankly, as a SAHM married to a guy who’s a good dad and with ONE kid, it wasn’t going to happen! I can only imagine single-parenting twins! *takes hat off, and passes chocolate*

BeatriceC

Ohhh! I had another thought. Do we have any programmers here? Maybe somebody could program a smart phone app for at least iOS and android to make tracking these thing easier and more convenient.

Charybdis

Great idea! If Dr. Amy would agree, it could be called the “Push Back” app.

BeatriceC

Now I’m starting to wish I didn’t brain dump all my computer science and programming classes in undergrad.

Mac Sherbert

That might work. Maybe we should start a page like ICAN and instead of listing which hospitals deny VBAC we could list hospitals that deny formula?

Charybdis

I think FFF has an informal list; she was asking for “bottle friendly hospital encounters” not too long ago.

Maybe a combo Facebook page between FFF and SOB?

indigosky

I did exactly that with baby #2. I would document the nurse’s name, the time I asked and the time they refused me. And the one nurse who would give me formula (and sent me home with a ton of RTF bottles) and “slipped” and gave me the direct emails and phone numbers of whom I needed to file my report to for faster action. The only reason she still worked there was to protect what patients she could. But she told me not to say anything or give her kudos, because that could get her fired because she was technically breaking hospital policy.

BeatriceC

Thank FSM for nurses like her.

indigosky

Ramen!

Brooke

Great. So when I refused formula for my son because I planned on breastfeeding & the nurse in the post partum floor was taking her sweet time getting me up to the NICU, that was neglect? Funny how my son didn’t starve to death and latched on perfectly well and actually gained weight in the hospital on breastmilk only.

guest

I was talked out of buying formula for “just in case” by an online pregnancy group. I was planning on breastfeeding, and had no idea about how often it fails, but I was still worried that as a single mother with babies due to be born in the middle of winter, I could face a situation where I was unable to leave the house and unable to feed the babies. It seems like a no-brainer, right? Have a backup food supply ready for all residents of the house? (We had recently gone through Hurricane Sandy, so disasters were more on my mind that lactation failure.) And multiple women told me not to do it, the temptation would be too great.

So. Stupid.

Allie P

“the temptation.” This attitude of a single drop of formula ruining it for you or the baby is RIDICULOUS. Formula saved my breastfeeding, BOTH times. I nursed 10 months with #1 and we’re well past that and still going with #2.

Sarah

You know how women are with temptation #sinsofeve

Roadstergal

Some moms even give their kids apples! And knowledge.

Charybdis

Shhh…..Demo will hear you! Her LO is an apple monster.

demodocus

So I cruelly denied him his 4th of the day.. (Fetched himself a 3rd while I had an unintentional, pregnancy induced nap) Good thing he can’t read.

KeeperOfTheBooks

Sounds like DD and strawberries. Overheard in the kitchen this morning, “No, you may NOT have a third bowl of strawberries; I have to change your diaper this afternoon! Have some yogurt!”

BeatriceC

Fair warning: It doesn’t get any better. I’ve spent a minor fortune in blueberries the last couple weeks because it’s one of the few things MK will eat. Under normal circumstances he’ll eat a pound in a five minute sitting. He’s always been this bad, from the time he could get his grubby little hands to cooperate long enough to pick one up and shove it into his mouth. YK is like that with broccoli and lettuce and OK is bad with bell peppers.

demodocus

Yeah, but then he’ll be wiping his own butt!

BeatriceC

Blueberry poop is an experience I hope never to have to repeat. Just saying.

Chant de la Mer

The seeds, wiping those blasted seeds off! The worst! So glad my last is getting close to potty training and I won’t have to deal with blueberry poop after that.

Who?

Some of us were having breakfast.

Were.

Just saying.

BeatriceC

Wuss.

Who?

Yes, yes I am.

But I do have useful skills in other areas.

BeatriceC

We all have our weaknesses. Lol.

Chant de la Mer

Sorry, but BeatriceC started it!

sdsures

I was nuts about watermelon as a kid. Still am!

guest

My kids were weird. They’d eat an entire punnet of berries as infants, but their poop didn’t show it. Then when I got them a blue-frosted birthday cake, oh THEN it showed.

KeeperOfTheBooks

Heh. Blueberries.
There was one weekend when I went to visit friends some 4 hours away, leaving DD with DH for a daddy-daughter weekend. As I left, I emphasized quite firmly that she’ll eat as many berries as you give her, so be careful!
Got home, saw the giant blueberry box sitting empty on the counter. Didn’t say anything, though, until DH sheepishly admitted to letting her eat as many as she liked (“they’re healthy!”), and, ummm, the resulting diaper had been locked in the downstairs bathroom, and, er, I might want to be careful when I opened that door because I’d release The Smell…
It was definitely one of those moments when I thought that cloth diapering was not one of my best or brightest ideas. I seriously considered tossing the whole thing in the trash, but couldn’t bear to throw away $20 worth of diaper, and opted instead to throw it in the washing machine and just keep hitting “wash cycle, 2 extra rinses” for the remainder of the evening. UGH.

Sarah

Whores.

guest

Apples are my son’s favorite fruit.

BeatriceC

Yes, because we wimmins don’t have three brain cells in our heads to make appropriate choices and are too ruled by emotion to make them even if we had the brain cells.

The Bofa on the Sofa

Well, just yesterday Dr Tamara said that women choosing formula were brainless, so that’s consistent.

CSN0116

These types talk about formula like it’s crack to a recovering addict. Seriously, read their shit ramblings and replace “crack” LOL.

guest

I will admit that sometimes I am very tempted to just have the kids watch TV all day to keep them from fighting and tearing the place apart. But, no one has ever suggested that I get rid of the TV, or not buy a TV in the first place because some day I might have kids and be “too tempted” to resist letting them watch too much.

#shitmom

guest

And there was one weekend where I came down with food poisoning and really did let them watch TV all weekend. Their brains don’t appear to have completely rotted, and there was no other way I could survive that weekend.

Mac Sherbert

I have let mine watch TV all on occasion….my son is still qualified as gifted and is a model student. 😉

The Computer Ate My Nym

My kid watches TV. Well, TV shows on Netflix. This has resulted in her writing fanfic versions of some of her favorite shows. Given that she’s dyslexic, I am not displeased with the results of allowing her to watch TV.

Lindsay

How stupid. My baby is exclusively breastfed/expressed milk fed, I produce enough milk to feed an army, there’s over 500 ounces stored in the freezer at this point, and we still keep formula in the house in case of emergencies. I’m not going to let my baby go hungry. Full stop.

BeatriceC

At one point I had over 50 gallons (no that’s not a typo) stored in my deep freezer. And it would have all been gone if I didn’t have a working generator when a couple major storms ripped through and knocked out power for three days.

Lindsay

I stopped adding to the store pretty quickly. We have never touched it, and it seemed like a waste of my time and our limited freezer space. I just dump any extra now, although I’ve considered donating. The oldest stuff in there is nearly 6 months old, so I might start swapping it out.

Lindsay

I’m pretty sure if be heavily shamed for dumping my “liquid gold” if I admitted that in certain places . . Shame I can’t use it to pay my student loans.

BeatriceC

You’re right. Part of why I had such a supply is that I felt guilty for dumping it and didn’t want to stop pumping because I lived in South Florida, where hurricanes and severe thunderstorms knock out power on a regular basis, and I was afraid that something might happen to what I already had stored.

guest

Oh, I just dumped it when my freezer was full.

CharlotteB

We got four of those little to-go formula packs (powered) when we registered. I was glad we had a tiny bit in the house–that was enough for 4, 4 oz bottles.

But get this. My husband was more pro-bf than I was (he wasn’t a jerk about it–long story, nor did he object to having that bit of formula), BUT the first night home, at some point in the middle of the night, baby wouldn’t latch, was crying, etc. Who said “Where’s the formula? I’m making a bottle!” It wasn’t me. It was him.

Point being, having it in the house means nothing. I was more hesitant to use it than he was, and I started out more lukewarm to the whole bf thing in the first place.

Sarah S

I talked myself out of having formula on hand with my second. I was going to do Everything Right to establish my supply early and well this time.

Yeah, wound up having to frantically buy some and then teach my ebf 2-day old how to use a bottle because after an initial rush of colostrum in the first 24 hours my boobs basically quit until my milk came in around 5-7 days pp. I’m just glad I realized he wasn’t getting enough pretty early. Took a month to get my supply up to where I could ebf, and that with the help of domperidone (in Canada, where it is legal).

MaineJen

“It…leaves personal decisions to the person actually affected by them, the mother.”

This is such an important point. No one should presume to know what is “good” for any particular woman, her baby and her family.

Megan

Totally agree. I did this with my second baby and she was much more settled and breasted well. I still didn’t make enough milk but that’s because I have IGT I’m sure if I had we’d be breastfeeding successfully.

Anyway, another point about bringing your own formula is that aside from preventing weight loss, dehydration and a lot of readmission for jaundice is that it prevents the false inflation of exclusive breastfeeding rates at discharge that most BFH have simply due to coercion and refusing to give moms formula. If moms bring their own formula, THEY decide if they want their baby to have it and not the staff (who are pressured to achieve a certain exclusive breastfeeding goal for discharge patients under the BFHI).

I had one nurse be very bitchy with me for giving my daughter a few mL’s of formula to help her breastfeed. I’m sure she would’ve given me a hard time if I hadn’t had my own and may have managed to prevent me from getting it. I now count as one of their patients who is not EBF and not helping them reach their target because they have to document all of baby’s feeds.

Inmara

That’s exactly my plan when (hopefully) I’ll have next child. If I had asked for formula, most probably I would have gotten it without much fuss, but I’m frustrated that nobody even offered me this option despite baby loosing more than 10% of weight. Now in hindsight I realize that my milk took several days to come in; I was not engorged for about a week and proper letdown reflex appeared at 2 months (!). Meanwhile, my roommates (2nd babies for both of them) complained about engorgement but one of them still had supplemented her baby in the first night (because he was 5 kg at birth and clearly needed more milk than mom could produce immediately after birth). I just had no idea what is the difference between hungry baby and “just crying” baby.

Penelope

My hospital was quick to come to me with formula supplementation, as I had gestational diabetes and they were worried about my baby’s blood glucose levels. I had no idea that this was being withheld from some mothers and babies. That is horrifying.

okayestmom

I totally agree. I did this with my youngest child’s birth.

Amy Tuteur, MD

Dr. Amy Tuteur is an obstetrician gynecologist. She received her undergraduate degree from Harvard College in 1979 and her medical degree from Boston University School of Medicine in 1984. Dr. Tuteur is a former clinical instructor at Harvard Medical School. She left the practice of medicine to raise her four children. Her book, Push Back: Guilt in the Age of Natural Parenting (HarperCollins) was published in 2016. She can be reached at DrAmy5 at aol dot com...
More